AFH Documents

AFH Documents

All Documents Will Be Emailed Within 24hr & Customized Will Be Emailed Within 48hr
Name of Requester*

First NameLast Name
E-mail To Send Documents *
example@example.com
Phone Number*
Pay Method*

Documents Requesting*

Program Statement

$60.00 Quantity

Customized Program Statement

Includes Your Logo Added, Business Name, Address, Number of Beds & Type Of Clients, House Description

$80.00 Quantity

Admission Agreement

$70.00 Quantity

Customized Admission Agreement

Include Your Logo & Business Name

$90.00 Quantity

Client Admission Documents

All Forms Required To Admit A Client And Required To Be In Client Folder. Also Some Forms Will Need To Be Submitted With AFH Application

$80.00 Quantity

Medication Folder And Charting

$15.00 Quantity

Employee Folder

$15.00 Quantity

Medical Incident Folder

$15.00 Quantity

All Folders

No Customized, No BSP (PROMOTION)

$190.00 Quantity

All Folders Including Custom

No BSP Included.. Customize Includes Adding Your Logo, Business Name, Address, Number of Beds & Type Of Clients, House Description

$250.00 Quantity

Behavioral Service Plan (BSP)

$40.00 Quantity

Individualized Service Plan (ISP)

editable

$40.00

Individualized Service Plan (Custom)

customized with name, and logo can be added

$60.00 Quantity

Application Process (Promotion)

You will receive step by step instructions. Only thing you will have to do on your end is create the floor plan and I’ll show you how that looks and then have someone come out to inspect the furnace Some of the requirements are to have an LLC, EIN and Business Account

$300.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Cash App Pay

Afterpay

Customized Information
Date Submitted*

MonthDayYear
Date
Signature

Powered by Jotform SignClear
Should be Empty: